I dreaded Mr. L’s office visits. His mouth half vacant of teeth and his clothes reeking of hand-rolled cigarettes, he regularly demanded medicines he didn’t need. He was pushy and thankless. I frequently declined his requests. He stuck with me anyway. Over the years he grew in orneriness. Divorced, childless, and unemployed, he declared one day that he was tired of living. He was reasonably healthy. He disavowed depression. Would I ...

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Spend time talking with non-medical friends and acquaintances. Ask them about their medical experiences. Imagine what they want, or ask them what they want. People want to feel that their physician has spent adequate time talking, examining and explaining. They want to look into the physician’s eyes. They want the best possible care, but caring matters. Our “system” discourages such care implicitly. Physicians do not get paid to spend time with patients. ...

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In a recent PBS interview, Mayo Clinic CEO Dr. John Noseworthy suggested patients should “change physicians” when faced with non-empathetic doctors suffering from burnout.  His cavalier resolution to our occupational struggle feels like a betrayal, to both his esteemed colleagues across the country and our profession.  In my opinion, firing your physician is a risky proposition in light of the looming physician shortage. Burnout is an overwhelming sense of ...

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“Listen, when I was your age, I did the same thing …” The words came out of my mouth too fast for my frontal cortex to weigh them or to monitor, let alone modulate, the intensity of my delivery. He was a relatively new patient, 17 years old, scheduled for a well-child exam. A tall, athletic young man, he was alone in the exam room. His right arm was in a sling. “What ...

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"If my father dies, you're going down with him." The words pierced the air, and suddenly there was silence. I hadn't noticed Frank’s son at first. He'd been pacing in the back of the family group gathered in our ICU waiting room. Now, up close, I could appreciate how large and intimidating he was. And I'd just had the thankless job of telling him, along with the rest of his family, a ...

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asco-logo Milly* was 82 years old and had been diagnosed with a recurrent ovarian stromal tumor — one that is typically seen in much younger women. Surgery was ruled out, and a colleague from outside of Boston sent Milly to me for an opinion about medical treatment. I reviewed her case before I met her: no significant medical problems, ...

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asco-logo My background in nursing has given me a perspective that many physicians don’t have. From the beginning of my career, I have valued the information that patients have provided me about the context of their lives, family, work, and beliefs. I have never cared for a knee or a prostate, but rather I have cared for a person whose life experiences ...

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Burnout is a popular topic of discussion among health care professionals, but preventing it often eludes us.  While burnout is common in many professions, it is particularly present in health care.  It is estimated that about half of all physicians in the United States suffer from burnout with numbers rising rapidly.  Burnout is associated with detachment from those around us and feelings of isolation.  Burnout can lead physicians to lose ...

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Otis was our first baby. He was covered in a caramel-colored fur, weighed 150 pounds and was the best bullmastiff dog anyone could ask for. He protected me from my husband’s incessant tickle attacks and thought that my lap was the best place for him to try and sit. Two years ago, I was walking Otis and he suddenly collapsed. After an extensive workup, including an EKG, blood work and an ...

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There are so many insightful stories out there about what happens when physicians experience life as a patient or family member. They always make sobering reading for everyone in health care. Over the years I’ve heard dozens of these stories from fellow physicians, describing experiences when they’ve unfortunately been sick themselves. It’s an inevitable fact of life for everyone that they will be the patient one day, but it’s often ...

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